


Just In Case There's a Next Time

by CardioKat



Category: Star Trek: Voyager
Genre: AU, Canon Compliant, Cardiophilia, Doctor/Patient, F/M, Fluff, Friendship, Heartbeats, Hurt/Comfort, Light Angst, Love, Major Character Injury, Medical, Medical Examination, OTP Feels, Realistic, episode rewrite
Language: English
Status: Completed
Published: 2020-03-09
Updated: 2020-03-09
Packaged: 2021-02-28 20:26:45
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 5,386
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/23083180
Author URL: https://archiveofourown.org/users/CardioKat/pseuds/CardioKat
Summary: This story is set as an AU scene for the episode “Future’s End” - S03E8/9This story begins assuming that it is Chakotay and Janeway who are piloting the shuttle over the desert, not B’Elanna. Captain Janeway is injured as their shuttle crashes in the California desert, and Chakotay has to rely on some old academy training and an antiquated tool to ensure she is okay.
Relationships: Chakotay & Kathryn Janeway, Chakotay/Kathryn Janeway
Comments: 2
Kudos: 47
Collections: Janeway/Chakotay





	Just In Case There's a Next Time

“Before we hit the ground, I saw a building nearby. We should head there for shelter until Voyager can beam us out.” 

He looked around, squinting at the sunlight that blanketed his view. He couldn’t be exactly sure without a tricorder, and it wasn’t something either of them thought to grab in the split second that they made an emergency beam out just before crashing. 

“I think it’s just about a mile that way,” Chakotay said, his free hand pointing into the landscape ahead of them made of blinding sunlight and endless sand. His other arm was wrapped around her waist, supporting her weight. “Can you make it?”

Kathryn grunted, steadying herself against him as she stood. “I don’t have a choice, do I?” she asked, a hint of humor in her strained voice. 

“Not really,” he said with a lighthearted, yet short-lived grin. He studied her as they prepared to walk ahead. She was obviously hurting, he could see it in her eyes, and he could certainly feel it in the way she leaned her weight into him. But she was trying her best to be strong, not wanting to let a little things like probably broken ribs and internal bleeding stop them from getting back to their ship and stopping Starling. He was definitely worried, hoping to get to shelter as quickly as possible so he could assess the damage as best he could. 

He tightened his grip around her as they started toward what he hopes was an empty building. As they trudged through the heat and sand, his mind flashed back to the moments before the crash. They were fired at from above, destroying the inertial dampers, which sent the shuttle into a free fall spinning out of control as it raced toward the surface. When the first blast hit the hull, she was thrown out of her chair and hit the side of the console to her left. She tried to get back to her chair, but when they started to spin she was thrown again to the floor. That’s when Chakotay initiated the beam out, knowing they likely wouldn’t survive the impact if they stayed. 

When they materialized onto the desert sand, she tried to stand up on her own, but the pain in her side stopped her instantly. He brought his arm under her shoulder and helped lift her to standing, surprised at how much of her own weight she wasn’t bearing on her own. That’s when he knew they needed to find a place to get out of the sun and rest as they waited for Voyager.

“There!” he said, panting from the heat as he pointed ahead of them. They could see the building now, though it was still a ways off, but at least they knew they were heading in the right direction. 

About an hour later, they managed to make it to the perimeter of the building. Without a tricorder to scan for lifesigns, they were going to have to look around before entering. Chakotay removed his arm from around Kathryn’s waist, steadying her as best he could on her own, and carefully made his way around the area. 

In just a few minutes, he came back and slipped his arm back around her. “All clear,” he said, as he helped her inside the shelter. 

They walked through the door to find what looked like an old warehouse. It was mostly empty except for some crates and boxes. It didn’t look like anyone had been here in a while, but it didn’t look completely abandoned either. He would have to keep on guard while they were there in case anyone decided to come home. 

He helped her to the back corner of the main room, away from the windows, just in case, and with a pained grunt she managed to get into a seated position on the floor against the wall. He sat next to her for a moment, looking her over to make sure she was alright. 

“Voyager will get here in no time, I’m sure of it,” he reassured her without provocation. She nodded in acknowledgement, watching as he took off his combadge and started taking it apart to activate a homing beacon. 

“Be careful, Chakotay,” she warned. “Make sure the signal isn’t traceable by any technology of this century. 

“Understood,” he replied, working quickly so he could get to his next task. When he finished, he set aside the combadge and turned to face her. “Kathryn, I need to examine your injury. I need to see if your ribs are broken and make sure there’s no internal bleeding.” 

“Alright,” she agreed, stifling a moan as she tried to readjust her position a little. 

“Without a tricorder this is going to be challenging to say the least,” he admitted, “but I’ll look around here to see if there’s at least a med kit or something of that nature. Don’t go anywhere.” He smiled wryly at her, trying to lighten the mood, and she gave a small smile in return before he stood and made his way toward the back rooms. 

When he came back to her a few minutes later, he was carrying a brown messenger bag. 

“I found this behind a desk in what I assume is the office for this place,” he explained, setting the bag down next to him as he sat by her left side. “It’s definitely a med kit, though obviously not Starfleet issue. But it’ll get the job done.” 

“Lucky break finding that here,” she said, seeming more alert now than before. He guessed she managed to find a comfortable position to sit in, comfortable enough to dull some of the pain at least. 

“Definitely,” he agreed, rummaging through the bag. There wasn’t much inside this med kit, but it seemed to have what he would need to make do. “Perfect!” he exclaimed under his breath as he pulled out a large roll of medical tape and a stethoscope. 

Kathryn’s eyes widened at the sight of the ancient tool in her first officer’s hand. “What is that?” she asked, wincing as she reflexively tried to sit up to get a closer look. 

“It’s a stethoscope,” he answered. “Didn’t you have to learn how to use this when you took Basic Field Medicine at The Academy?”

She shook her head, grinning. “I guess my professor decided to skip the unit on archaic medical technology, figuring we would never actually be in a situation where we would need to use one.”

Chakotay chuckled. “He obviously figured wrong,” he said looking around at their surroundings, noting this exact situation. “Without a tricorder I can’t scan you to see if your ribs are broken or if maybe even one of them punctured a lung. But with this I can listen to your lungs to know if there’s any fluid inside.”

“I see,” she replied cautiously before letting out a short huff of laughter. “Good thing you’re the one that has to examine me or I suppose we’d be in trouble.” 

“I wouldn’t go that far,” he reassured her. “We may be stuck in primitive times, but at least they left me something to work with here. I’ll need you to remove your jacket and turtleneck if you can, so I can reach the injury easier. Can you do that?”

“I don’t have much of a choice, do I?” she repeated from earlier with the same smirk, and he smiled back. 

She managed to sit up, and he helped her slide her arms out of her jacket before unbuttoning her turtleneck for her. Once she was out of her outer layers, she sat back against the wall, and he rolled up his sleeves a bit. 

“First I’m going to feel the injured area to check for fractures or breaks,” he explained. He looked at her apologetically as he added, “this might hurt a little.”

“Understood,” she said, bracing herself. 

He lightly placed his hand on her right side, knowing the main injury occurred on her left but wanting to make sure there weren’t other fractures they didn’t anticipate. He pressed gently but firmly on each bone, feeling through her tank top material for any cracks or breaks. He found none on the right, so he moved over to the side she was favoring. 

He pressed into her bottom rib and she gasped. “I’m sorry,” he said, pausing his exam.”

She shook her head. “No, it’s alright,” she assured him. “You need to keep going.”

He took a breath before beginning again, feeling as gently as he could as he found two ribs that were certainly not in their right shape or place. He sighed as he pulled his hand away. 

“You have at least two broken ribs, maybe a third or a fracture,” he stated as he picked up the stethoscope. “I’m going to listen to your lungs now to make sure there’s no puncture or fluid that we need to worry about. I’m hoping it’s just a couple of breaks.”

“Me too,” she agreed, eyeing the stethoscope warily. “Are you sure that thing still works?” 

He grinned as he placed the earpieces in his ears. “I’m sure it does. Now lie still and just breathe when I tell you to.”

He picked up the receiver and placed it at the top of the right side of her chest. He knew he was supposed to listen to her breathing, but when the sound of her heartbeat resonated through the device and filled his head, he couldn’t help but freeze in the moment. He had never imagined getting to hear her like this, though he certainly would have preferred it under different circumstances. He could have listed to her steady rhythm for hours, but after a brief moment, shook himself out of his thoughts. 

“Take a deep breath in,” he instructed, waiting and watching as her chest rose against his hand. He moved the stethoscope to the other side, just above her heart and instructed her to breathe again. She complied, and he was relieved to hear normal sounds so far. 

“Breathe in,” he said as he placed the device on her right side again, this time just below her breast, and she closed her eyes as her chest filled with air. Afterward, he moved it slightly to his right and pressed it down as she inhaled another time. 

He cautiously moved his hand to where her injury was, carefully placing the stethoscope just above her broken bones and asked her to breathe a few times, listening closely for any abnormal sounds. He was more than relieved to find that her lungs sounded clear from the front, but he could hear creaking and racking from where her bones were severed, rubbing against each other as she took each breath. This must hurt like hell, he thought to himself before asking her to take one last breath. 

“So far so good,” he announced as she opened her eyes, removing his hand from her chest. “Your lungs sound clear at the front. I just have to listen to the back to make sure.”

“That’s good,” she agreed and did her best to sit up without letting the pain show. She knew he probably already felt awful about having to hurt her before and didn’t want to make him feel even worse as she did what he asked. 

He held her gaze as moved himself a bit closer to her, trying to silently reassure her that he would work as fast as possible so she could relax again. He lifted his arm and wrapped it around the front of her torso so she could rest some of her weight into him as he placed the stethoscope on her back, just above the seam of her tank top. 

“Breathe in,” he said as he sat with his arms wrapped around her. He moved the stethoscope to the other side of her back, pressing against her skin, and asked her to breathe again. 

He could feel her chest expand against his arm, and he tried not to let that distract him while he needed to listen so closely. He moved lower, careful not to push too hard as he asked her to breathe in as deep as she could. Her breath sounded clear, but he could feel her struggle to expand her chest against him. 

“Just a few more,” he said, reassuring her that it would be over soon. He moved to her lower back, just on the other side of the injury. She inhaled as best she could and he could hear soft creaking sounds, but there was no sign of fluid at all. 

He pulled his hand away and gently helped her sit back against the wall. “Your lungs are clear for now,” he reported, taking the earpieces out and putting the stethoscope in the bag. “There’s some definite movement in your bones when you breathe, but it doesn’t sound like anything is punctured. I’ll listen again in a little while to make sure, if Voyager hasn’t found us by then.”

“Thank you,” she said sincerely as she readjusted, wincing a little. He turned away to check on the homing signal, and Kathryn found herself getting lost in her thoughts. 

She had never experienced an examination like that before. Not just because the tool was new to her, but because she had never felt so desperately cared for. She could feel warmth in his touch, even through the cold metal. She could feel his care for her as she leaned against him, breathing against his arm as he steadied her. She could tell he felt awful for having to cause her pain, but at the same time, she felt something wonderful in his touch even when it hurt the most. 

She hesitated to think what would have happened if their roles were reversed. If he had been hurt instead of her. Without a tricorder and not knowing how to use primitive medical tools, she wouldn’t have known how to tell if there was internal bleeding. She silently cursed her professor for something she used to thank him for back in her academy days, not knowing then how much he actually was doing a disservice to his students. 

He was about to move the bag off to the side when she placed a hand on his arm to stop him. 

“Chakotay,” she started, “I was just thinking to myself. If this situation was reversed, and you were the one who got hurt, I wouldn’t have been able to help you the way you just took care of me.”

“You would have found a way,” he assured her with a gentle smile. 

“Maybe,” she smirked slightly, “but I’d rather not take my chances on next time.”

Curious, he asked, “What do you mean?”

“Will you teach me how to use that?” she asked, indicating toward the object in inside the med kit. 

He smiled at her. “Absolutely.” She tried to sit up a bit more, but he put a hand on her shoulder to stop her. “Relax, Kathryn. I’ll come to you.” He took the stethoscope out of the bag and moved closer to her once again. 

He handed the scope to her to let her explore it a bit as he explained. “This is basically an amplification device that lets the listener focus in on sounds that are internal or behind barriers. Centuries ago, thieves and bank robbers used to use these to listen to vaults, so they could hear the clicks in combination locks and crack the code.”

“Multipurpose, very efficient,” she joked as he ran her hands along the black tubing between the ear pieces and the receiver. 

He chuckled as he continued. “Before scanning devices were created, doctors used these to listen to a patient’s internal organs like the heart, the lungs, the stomach, liver, etcetera, because that was their only way to diagnose any irregularities within the body. They couldn’t see inside, but they could hear everything. This device let them do that in a way that was precise.”

He took the stethoscope from her hands and picked up the receiver to show her. “This part can be used two ways. The larger part, called the diaphragm, is used the most often, picking up a wide range of sounds and pitches. This part on the other side of that, the smaller side, is called the bell, and it picks up higher pitches and more specific sounds.”

“I’m going to let you listen to me,” he said as he started to take off his jacket. “You’ve had enough moving around for the time being.” She smiled thankfully at him. Once finished he pushed his uniform jacket and turtleneck aside and picked up the stethoscope.

He handed her the earpieces. “Once you place these in your ears, anything you place the diaphragm against will be louder, but everything else around you will be muffled. You’ll be able to hear my voice through the stethoscope as I talk you through how to listen and what to listen for. Got it?”

“Yes,” she said, putting the ear pieces in. As soon as they were in place, she understood what he meant. It sounded like she was underwater. He still had the receiver in his hand, and she could hear loud brushes as his hands adjusted around it. 

“We’re going to start with my heart,” he said, slowly, so she could understand him through the muffled white noise. He then placed the diaphragm on the upper right side of his chest. 

She closed her eyes. So many sounds flooded Kathryn’s ears at once. She could hear his fingers brush the receiver still as he adjusted the piece in place, and she heard all kinds of percussive noise in the background. But what she tried to focus on what his heartbeat, loud and clear as if it were hooked up to a speaker and it was being played just for her. She could have listened to it forever, but she was broken out of her trance by his voice booming through his chest. 

“Kathryn, can you hear me?” he asked, trying to hide a smile as he watched her listen so intently.

Her eyes popped open when his voice resounded. “Yes,” she answered, shaking her head a little. 

“Okay,” he began, keeping the diaphragm in place as he spoke. “There are five places on the chest where you want to listen to someone’s heart so you can make sure you hear all of the valves and muscles. That way you can make sure the entire organ is functioning and working with the systems around it.” He was trying to sound as technical as possible, both so she could learn the science of it and so he could keep it as professional as he could manage to. 

“What am I listening for?” she asked, trying to focus on the sound as scientifically as she could. 

“Everyone’s heart has a regular rhythm, and this rhythm gets faster and slower depending on how a person feels, physically, emotionally and otherwise. If the rhythm is regular and not too fast or too slow, then there is nothing really wrong. But if you hear missed beats, or extra beats in the rhythm or the heart is going too fast to be safe or too slow to pump blood efficiently, then those are cause for concern.”

“I see,” she responded softly, still marveling at the sounds she was hearing. 

“This spot is called ‘Aortic,’” he explained, letting her listen for a moment longer before moving to the other side of his chest. He placed the diaphragm down softly before stating that this was the pulmonic point. 

She listened as closely as she could, noting the differences in sound between the two places in his chest. His rhythm was steady, almost like a waltz. She hadn’t heard anything irregular, so she assumed this was what a normal, healthy heart was supposed to sound like.

“Ready to keep going?” He asked, and she nodded. He moved the stethoscope almost to the center of his chest, slightly to his left. “This is Erb’s point, and as we move around the heart you’ll notice that the beats get a little louder now.”

She closed her eyes. He wasn’t exaggerating. Chakotay’s heartbeat flooded her ears and she smiled in spite of herself as she heard the rhythm so loud and clear. He noticed her response, and it made his heartbeat pick up speed. She opened her eyes and looked into his with concern. 

“Your heart just got really fast,” she noted. “Are you okay? Do we need to stop?”

He laughed softly. “No I’m fine. It can happen from time to time during examinations.”

She grinned wryly at him. “Are you nervous, Commander?”

He tugged at his ear, giving his emotions away, as he replied, “That’s professor to you, right now, cadet.”

She laughed, wincing as she was reminded of the pain in her side. He noticed and put the receiver down, moving his hand to her side to offer comfort. 

“Do you need to stop?” he asked in return.

She shook her head. “I need to stop laughing maybe, but no I’m fine to continue. I’m learning a lot.”

“Good,” he replied, and he picked up the stethoscope again, placing it just below its last position. “This point is called ‘tricuspid’ and it is often the loudest of the five.”

“It certainly is,” she agreed, listening calmly for a few moments before he moved again. He placed the diaphragm just under his pectoral muscle, almost off to the side of his chest. This sound was the most unique of all of them, both clear and muffled at the same time, with lots of extra sounds coming from all over. She could also hear him breathing, so it was hard to focus. 

“This is the Mitral area,” he stated. “It’s right over the lower valves so it can be a good place to listen to make sure there’s good blood flow.

“Makes sense, “ she responded, listening intently before he spoke again.

“After you listen to each area with the diaphragm, if you feel that you need to listen for higher pitched sounds, you switch to the bell and listen to each spot again. I’ll love through the placements so you can hear the difference in sound for each one.”

She nodded and he slowly placed the bell on each of the five spots on his chest, giving her a few moments to listen carefully at each point. He tried to keep his breathing shallow so she could isolate the heart sounds, but with his heart rate increasing, it was difficult to keep from panting a bit. 

After a few moments he put the receiver down and motioned for her to remove the earpieces. 

“Let your ears rest for a moment before we keep going,” he recommended, and she nodded. He rested the stethoscope next to her before continuing his lesson. “Next, I’ll show you how to check for irregularities in breathing sounds, which is basically how I examined you earlier. There are several points you can listen to, and lungs can be heard through the chest and through the back.”

“What am I listening for here?” she asked. 

“Normal breathing sounds like a balloon filling up with air. You’re hoping to hear uninterrupted sounds of oxygen filling the person’s lungs. When you hear crackling, bubbling or broken inhalations is when you’ve encountered a problem. When I was listening to you, I was hoping not to hear any crackling or bubbling because that would indicate that you had some fluid in your lungs. When you’re looking at a broken rib, fluid in the lungs can mean blood pooling in from a puncture wound, which is worst-case scenario.”

“I see,” she replied, thankful that he had found nothing of that sort when he examined her. 

“Ready for more?” he asked, picking up the stethoscope again.

“Absolutely,” she smiled at him, grateful for his teachings despite the circumstances. 

She placed the earpieces back in, and he put the receiver on his chest in the upper right corner again before speaking. 

“There are a minimum of four places you should listen for breath sounds on each side of the body, more if you’re worried about an injury in a specific place. You basically want to make an upside down trapezoid on the person’s chest, and one that is right side up on their back. Once you have the diaphragm in place, you instruct your patient to breathe deeply so you can hear a long, slow inhalation of air.” As he finished he took a deep, slow breath.

“Wow…” The word slipped out quietly as she listed to the sound of his breathing. It was long, steady and slow, just as he said it should be, and she found herself at least a little relieved to know he was perfectly healthy. 

He moved the diaphragm to the other side of his chest, above his heart and breathed deeply again, slowly so she could listen as long as she needed to.

As he moved the stethoscope lower, near the mitral heart position, she noticed that the sounds were slightly different in this new place. Louder yet more muffled, she supposed due to the fact that she was listening to the bottom of his lungs that didn’t have as much air travelling through them. He moved the scope to the opposite side, staying low and over his ribs, he took a few more deep breaths, studying her as she listened to him. 

She seemed to fascinated and yet relaxed at the same time. Her scientific curiosity was definitely peaking here, but he wondered if she was as comforted by his sounds as he was by hers. He wondered if she was as nervous too. This wasn’t exactly a situation he ever imagined them being in, closer than he could have ever believed they would get You can’t get much closer to someone than inside their chest, listening to their heartbeat, focusing on their breathing. 

After a minute or so, he took the receiver away again, and she removed the stethoscope form her ears so she could hear him. He moved closer to her, close enough that she could reach him easily without straining her body. 

“I’m going to turn around and talk you through where to place the diaphragm as you listen through my back, okay?” he offered and she nodded, taking the stethoscope from him entirely and putting it back in her ears. 

Once he turned around, he reached over his shoulder and pointed to where she should first listen, and she placed the scope on the upper left section of his back, directly on his skin above his tank top, just as he did with her. 

Once she had it in place, she took his cue from before and asked him to breathe in, to which he complied. She felt his torso expand slowly against her hand and she could hear how different his breathing sounded from this spot. 

“Now move to the same place on the opposite side of my back,” he said, speaking slowly so she could hear him through the stethoscope. She did as she was asked and she listened to his breathing again. Afterwards, he reached around with his arm again, pointing to a spot lower on his back on his left side, and she moved her hand there, placing the stethoscope over his tank top right where he indicated.

“Breathe in,” she instructed, and she listed again as he took in a long slow draw of air. It sounded so different there than the other places. “Again,” she said, and he smiled through his breath, enjoying being the subject of her scientific curiosity. 

“Now move to the other side, same position, for one last time,” he told her. She gently released the diaphragm and moved it as instructed, asking him to breathe as deeply as he could. It was remarkable how much she could hear with such a flimsy, archaic tool. 

When she put her hand down, and started to take the earpieces out, he turned around and stopped her from doing so. He picked up the receiver and placed it on his chest so she could hear his voice better. 

“I want you to hear what it shouldn’t sound like, so you know what it is you’re looking for in case there is a next time,” he explained. “I’m going to move this to just above your injury, and then I want you to breathe slowly and naturally, listening any abnormal sounds. You should at least here some creaking, but I hope that’s all.”

“Okay,” she agreed, and he moved the stethoscope from his chest to hers, just above her broken bones. She winced a little at the pressure, but as soon as she focused in, she heard it. It sounded awful. She could hear crackling like paper as she took each breath, and she could hear creaking in her bones, as if they were rubbing against each other as her chest expanded. No wonder she hurt like hell. 

“I see,” she said, finally, and he put his hand down, letting the stethoscope fall loose. He took the earpieces out for the last time and set the contraption aside. 

“Well I hope you enjoyed your lesson today, Kathryn,” he joked. “Make sure you put in your report to Starfleet that I did your professor’s job for him, decades later.”

She chuckled softly, trying not to move too much. “I’ll make sure they know what an excellent teacher you are. Have you ever thought about teaching at the academy when we get home?”

He sighed and was about to answer when his combadge finally chirped.

“Chakotay to Voyager, do you read me?”

Ensign Kim’s voice sounded through static and the background noise of hurried officers moving around the bridge. 

“We’re on our way too you now. Sorry it took so long, we ran into a couple problems…”

“The captain needs medical attention, so beam us directly to sickbay when you get a lock.”

“Understood. Kim out.”

Chakotay looked at Kathryn with a smile, knowing that she was going to be alright. In a few minutes, they dematerialized, leaving no trace that they were there except for a discarded stethoscope laying on the floor of an empty warehouse. 

Back on her feet after recovering from her broken ribs, as well as a plasma burn from manually launching a torpedo at Starling’s ship, the Captain sat on the bridge buried in reports. Damage to the ship was heavy but manageable, but the damage to morale was another story. Everyone was having a hard time coming to terms with the fact that they had made it home, but they were still so far away. And even though she tried to have Braxton place them in the Alpha Quadrant when he fixed the time paradox, in the end, they ended up right back where they started. It was going to take some time before everyone could truly accept this, and until then, she needed to press on as best she could.

After a long bridge shift, Chakotay reminded her that the Doctor ordered her to rest as much as possible. With a roll of her eyes, she relinquished command to him and made her way to her quarters. She opened the door and went straight for the replicator, ordering some herbal tea to help get her relaxed and ready to sleep. As she walked over toward the couch she noticed something sitting on her coffee table.

Lying on the table next to a handwritten note was a maroon stethoscope, just like the one she used in the warehouse. She exhaled as she picked it up, looking it over curiously. After a moment she put it down and picked up the note that was next to it. It said: 

“Just in case you want to practice…for next time”

-Chakotay

She smiled, setting the note down and picking the stethoscope back up. She was certain there was more to learn, and just in case she ever found herself in a similar situation, she probably should. And she knew just the instructor to ask for lessons.


End file.
